Provider Demographics
NPI:1356403828
Name:GRIMSLEY, LORIN E (RD, LDN, CDE)
Entity type:Individual
Prefix:MRS
First Name:LORIN
Middle Name:E
Last Name:GRIMSLEY
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1348 INDIAN CAVE RD
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:TN
Mailing Address - Zip Code:37820-3539
Mailing Address - Country:US
Mailing Address - Phone:865-544-8287
Mailing Address - Fax:865-544-8247
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:BOX 49
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-544-8287
Practice Address - Fax:865-544-8247
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1074133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered